Comparison of clinical outcomes of intravascular ultrasound-calcified nodule between percutaneous coronary intervention with versus without rotational atherectomy in a propensity-score matched analysis.
<h4>Objectives</h4>This study aimed to compare the mid-term clinical outcomes of intravascular ultrasound (IVUS)-calcified nodules between percutaneous coronary intervention (PCI) with and without rotational atherectomy (RA).<h4>Background</h4>There has been a debate whether...
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doaj-cccdca2668a1473495780e7766c9f28a2021-03-04T12:29:59ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-011511e024183610.1371/journal.pone.0241836Comparison of clinical outcomes of intravascular ultrasound-calcified nodule between percutaneous coronary intervention with versus without rotational atherectomy in a propensity-score matched analysis.Yusuke WatanabeKenichi SakakuraYousuke TaniguchiKei YamamotoMasaru SeguchiTakunori TsukuiHiroyuki JinnouchiHiroshi WadaShin-Ichi MomomuraHideo Fujita<h4>Objectives</h4>This study aimed to compare the mid-term clinical outcomes of intravascular ultrasound (IVUS)-calcified nodules between percutaneous coronary intervention (PCI) with and without rotational atherectomy (RA).<h4>Background</h4>There has been a debate whether to use RA for the revascularization of calcified nodule. Although RA can ablate the calcified structure within calcified nodule and may facilitate adequate stent expansion, RA may provoke severe coronary perforation, because calcified nodule typically shows eccentric calcification.<h4>Methods</h4>We included 204 lesions with IVUS-calcified nodule, and divided into 73 lesions treated with RA (RA group) and 131 lesions without RA (non-RA group). After propensity-score matching, 42 lesions with RA (matched RA group) and 42 lesions without RA (matched non-RA group) were selected. We compared the clinical characteristics and outcomes between the 2 groups before and after propensity-score matching. The primary endpoint was ischemia-driven target vessel revascularization (TVR) within 1 year.<h4>Results</h4>Acute lumen area gain on IVUS was comparable between the matched RA group and matched non-RA group (3.9 ± 2.1 mm2 vs. 3.4 ± 1.6 mm2, p = 0.18). The stent malapposition at calcified nodules was frequently observed in both groups. The ischemia-driven TVR was not different between the 2 groups before (p = 0.82) and after propensity score-matching (p = 0.87).<h4>Conclusions</h4>The use of RA could not reduce the incidence of ischemia-driven TVR in lesions with IVUS-calcified nodule. Our results do not support the routine use of RA for lesions with IVUS-calcified nodule.https://doi.org/10.1371/journal.pone.0241836 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yusuke Watanabe Kenichi Sakakura Yousuke Taniguchi Kei Yamamoto Masaru Seguchi Takunori Tsukui Hiroyuki Jinnouchi Hiroshi Wada Shin-Ichi Momomura Hideo Fujita |
spellingShingle |
Yusuke Watanabe Kenichi Sakakura Yousuke Taniguchi Kei Yamamoto Masaru Seguchi Takunori Tsukui Hiroyuki Jinnouchi Hiroshi Wada Shin-Ichi Momomura Hideo Fujita Comparison of clinical outcomes of intravascular ultrasound-calcified nodule between percutaneous coronary intervention with versus without rotational atherectomy in a propensity-score matched analysis. PLoS ONE |
author_facet |
Yusuke Watanabe Kenichi Sakakura Yousuke Taniguchi Kei Yamamoto Masaru Seguchi Takunori Tsukui Hiroyuki Jinnouchi Hiroshi Wada Shin-Ichi Momomura Hideo Fujita |
author_sort |
Yusuke Watanabe |
title |
Comparison of clinical outcomes of intravascular ultrasound-calcified nodule between percutaneous coronary intervention with versus without rotational atherectomy in a propensity-score matched analysis. |
title_short |
Comparison of clinical outcomes of intravascular ultrasound-calcified nodule between percutaneous coronary intervention with versus without rotational atherectomy in a propensity-score matched analysis. |
title_full |
Comparison of clinical outcomes of intravascular ultrasound-calcified nodule between percutaneous coronary intervention with versus without rotational atherectomy in a propensity-score matched analysis. |
title_fullStr |
Comparison of clinical outcomes of intravascular ultrasound-calcified nodule between percutaneous coronary intervention with versus without rotational atherectomy in a propensity-score matched analysis. |
title_full_unstemmed |
Comparison of clinical outcomes of intravascular ultrasound-calcified nodule between percutaneous coronary intervention with versus without rotational atherectomy in a propensity-score matched analysis. |
title_sort |
comparison of clinical outcomes of intravascular ultrasound-calcified nodule between percutaneous coronary intervention with versus without rotational atherectomy in a propensity-score matched analysis. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2020-01-01 |
description |
<h4>Objectives</h4>This study aimed to compare the mid-term clinical outcomes of intravascular ultrasound (IVUS)-calcified nodules between percutaneous coronary intervention (PCI) with and without rotational atherectomy (RA).<h4>Background</h4>There has been a debate whether to use RA for the revascularization of calcified nodule. Although RA can ablate the calcified structure within calcified nodule and may facilitate adequate stent expansion, RA may provoke severe coronary perforation, because calcified nodule typically shows eccentric calcification.<h4>Methods</h4>We included 204 lesions with IVUS-calcified nodule, and divided into 73 lesions treated with RA (RA group) and 131 lesions without RA (non-RA group). After propensity-score matching, 42 lesions with RA (matched RA group) and 42 lesions without RA (matched non-RA group) were selected. We compared the clinical characteristics and outcomes between the 2 groups before and after propensity-score matching. The primary endpoint was ischemia-driven target vessel revascularization (TVR) within 1 year.<h4>Results</h4>Acute lumen area gain on IVUS was comparable between the matched RA group and matched non-RA group (3.9 ± 2.1 mm2 vs. 3.4 ± 1.6 mm2, p = 0.18). The stent malapposition at calcified nodules was frequently observed in both groups. The ischemia-driven TVR was not different between the 2 groups before (p = 0.82) and after propensity score-matching (p = 0.87).<h4>Conclusions</h4>The use of RA could not reduce the incidence of ischemia-driven TVR in lesions with IVUS-calcified nodule. Our results do not support the routine use of RA for lesions with IVUS-calcified nodule. |
url |
https://doi.org/10.1371/journal.pone.0241836 |
work_keys_str_mv |
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